Comparison of gadoxetic acid versus gadopentetate dimeglumine for the detection of hepatocellular carcinoma at 1.5 T using the liver imaging reporting and data system (LI-RADS v.2017)
Comparison of gadoxetic acid versus gadopentetate dimeglumine for the detection of hepatocellular carcinoma at 1.5 T using the liver imaging reporting and data system (LI-RADS v.2017)
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DOI：
10.1186/s40644-018-0183-3
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发表时间：
2018-12-07
期刊：
影响因子：
4.9
通讯作者：
Zeng, Mengsu
中科院分区：
文献类型：
--
作者：
Ding, Ying;Rao, Sheng-xiang;Zeng, Mengsu
目的：本研究的目的是研究肝脏成像报告和数据系统（LI-RADS）v. 2017，用于对钆塞酸与钆喷酸二甲胺增强的1.5-T磁共振成像（MRI）进行比较的肝细胞癌（HCC）分类。材料和方法：我们纳入了141例高危患者，其中145例经病理证实的HCC，他们首先接受了钆喷酸二甲胺增强的1.5-T，然后是钆塞酸增强的1.5-T。T核磁共振成像。两名独立的放射科医生评估了主要HCC特征的存在或不存在，并在考虑两次MRI的辅助特征后分配了LI-RADS类别。最后，使用Wilcoxon检验比较钆塞酸和钆喷酸二甲胺增强的1.5 T MRI之间LI-RADS 5类（LR-5）的灵敏度和主要HCC特征的频率。LR-5在钆塞酸和钆喷酸二甲胺增强MRI中诊断HCC的敏感性有显著差异（73.8% [107/145] vs 26.2% [38/145]，P < 0.001; 71% [103/145] vs 29% [42/145]，P < 0.001）。在主要的HCC LI-RADS特征中，钆塞酸增强MRI比钆喷酸二甲胺增强MRI更少显示包膜（3.4% [5/145] vs 5.5% [8/145]，P = 0.793; 4.1% [6/145] vs 5.5% [8/145]，P = 0.87，分别针对审查者1和2），钆喷酸葡胺组与钆喷酸葡胺组的动脉增强发生率无显著性差异（89% [129/145] vs 89% [129/145]，P = 1.000）。此外，钆塞酸增强MRI上，移行期（TP）出现洗脱的频率低于门静脉期（PVP（43% [46/107] vs 57% [61/107]，P = 0.367）。对于肝癌的诊断，钆乙酸增强MRI显示出与钆喷酸二甲胺增强MRI相当的灵敏度，根据LI-RADS v. 2017，考虑到主要特征，LI-RADS 4类（LR-4）肝结节升级为LR-5。
Purpose: The goal of this study was to investigate the Liver Imaging Reporting and Data System (LI-RADS) v. 2017 for the categorization of hepatocellular carcinomas (HCCs) with gadoxetic acid compared with gadopentetate dimeglumine-enhanced 1.5-T magnetic resonance imaging (MRI).Material and methods: We included 141 high-risk patients with 145 pathologically-confirmed HCCs who first underwent gadopentetate dimeglumine-enhanced 1.5-T followed by gadoxetic acid-enhanced 1.5-T MRI. Two independent radiologists evaluated the presence or absence of major HCC features and assigned LI-RADS categories after considering ancillary features on both MRIs. Finally, the sensitivity of LI-RADS category 5 (LR-5) and the frequencies of major HCC features were compared between gadoxetic acid-and gadopentetate dimeglumine-enhanced 1.5-T MRI using the Wilcoxon test.Results: The sensitivity of LR-5 for diagnosing HCCs was significantly different between gadoxetic acid-and gadopentetate dimeglumine-enhanced MRI (73.8% [107/145] vs 26.2% [38/145], P < 0.001; 71% [103/145] vs 29% [42/145], P < 0.001 for reviewers 1 and 2, respectively). Among the major HCC LI-RADS features, capsule appearance was less frequently demonstrated on gadoxetic acid-enhanced MRI than on gadopentetate dimeglumine-enhanced MRI (3.4% [5/145] vs 5.5% [8/145], P = 0.793; 4.1% [6/145] vs 5.5% [8/145], P = 0.87 for reviewers 1 and 2, respectively), and the frequency of arterial hyperenhancement was not significantly different between gadoxetic acid and gadopentetate dimeglumine (89% [129/145] vs 89% [129/145], P = 1.000). In addition, the frequency of a washout appearance was less in the transitional phase (TP) than in the portal venous phase (PVP) on gadoxetic acid-enhanced MRI (43% [46/107] vs 57% [61/107], P = 0.367).Conclusion: Gadoxetic acid-enhanced MRI showed a comparable sensitivity to gadopentetate dimeglumine-enhanced MRI for the diagnosis of HCCs, and LI-RADS category 4 (LR-4) hepatic nodules were upgraded to LR-5 when taking into account the major features according to LI-RADS v. 2017.